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Canada's top doctor continues stroke recovery

OTTAWA - All Dr. David Butler-Jones saw was a glow of light. And then strange things started happening.

At first, he thought it was a migraine coming on. But soon, Canada's chief public health officer realized that it was more than just a headache.

He was having a stroke.

Butler-Jones, dubbed Canada's top doctor in his role as head of the Public Health Agency of Canada, has been recovering since he was stricken in mid-May. It's been a difficult struggle.

From the outset, he was his own worst enemy. Being a doctor, Butler-Jones said he started to self-diagnose.

"I watched it evolving, trying to talk myself out of it being a stroke," he said.

At first he felt an "aura" of light passing his eyes. During supper, he noticed a difficulty swallowing. Feeling tired, Butler-Jones went to bed for the night. The next morning, things got worse.

By then it was too late for any kind of emergency treatment for stroke, such as a clot-busting drug known as tPA (tissue plasminogen activator).

A tPA is a thrombolytic drug that can stop a stroke caused by a blood clot by breaking up the clot. It can only be given to patients who are having a stroke caused by a blood clot, or ischemic stroke and must be given within three hours of the onset of symptoms.

Despite clear symptoms, the 59-year-old still thought twice about seeking treatment _ something he now regrets, especially given his family history.

His dad had his first stroke in his early 50s. His grandfather died at an early age from a heart attack.

Butler-Jones himself has asthma and an underlying immune deficiency that makes him prone to pneumonia.

"They say that doctors don't make the best patients, and that's probably true," he told The Canadian Press in an exclusive interview.

Butler-Jones said he didn't want to be a burden on busy emergency room doctors, especially if he was just getting a migraine.

He gave in the next morning when he realized he had difficulty moving.

"I never thought seriously about a stroke... but when I woke up in the morning, suddenly it's like 'oh, I'm walking funny'," he said.

Butler-Jones' initial reaction to having a stroke is not uncommon, says Dr. Michael Hill, associate dean of clinical research at the University of Calgary's Faculty of Medicine.

"A stroke by definition affects the very organ that gives you insight into what you're supposed to be doing," said Hill, who is also director of the stroke unit for the Calgary Stroke Program.

"Most times it's actually a bystander or a family member who is activating the emergency medical services to get somebody to help."

Those ads seen recently on TV and in publications across the country about recognizing the signs of stroke aren't so much for people who are hit by one, said Hill.

Rather, they are more for people who notice that someone else might be having a stroke.

Butler-Jones is perhaps best known as one of the main faces of Canada's response to the H1N1 pandemic in 2009.

He has had a long career in public health, both in Ontario and Saskatchewan, where he served as the province's chief medical health officer from 1995 to 2002. He was named Canada's first chief public health officer in 2004, following the 2003 SARS outbreak.

His biggest fear once the reality of having a stroke set in was that he wouldn't be able to return to work, just as his father's career ended following his stroke.

But after months of therapy, Butler-Jones is back at work, at least on a part-time basis.

It hasn't been easy, going through the challenges of therapy, dealing with bouts of depression and trying to improve his memory.

And Butler-Jones is resigned to the fact that he may never fully recover. But there is hope, he said, because he's still alive, and now able to work again, even if it's not at full speed.

"People, they can have a life and do well, in spite of the challenges," he said.

"So there's still hope. And that's my job now, to play the cards I've been dealt as best I can."

Upwards of 50,000 Canadians suffer from strokes each year. About 16,000 die, more often women than men, according to the Heart and Stroke Foundation of Canada.